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THE BASIC PRINCIPLES OF NUTRITON Prof. Dr.Ahmet Aydın 1 NUTRITIONAL REQUIREMENTS Individual nutritional requirements vary with genetic and metabolic differences. For infants and children, the basic goals are satisfactory growth and the avoidance of deficiency states. Good nutrition helps to prevent acute and chronic illness and to develop physical and mental potential; it should also provide reserves for stress. Water Water is essential for existence; a lack of it results in death in a matter of days. The water content of infants is relatively higher than that of adults (Table-1). Table 1. Growth and body fluid compartments. Parameter/ age Premature Newborn 1 year Adult Body weight (kg) 1.5 33 10 70 Body surface (m2) 0.15 0.20 0.50 1.70 Body surface / weight 0.10 0.07 0.05 0.02 Total body fluid (%) 80 78 65 60 Extracellular fluid (%) 50 45 25 20 Intracellular fluid (%) 30 33 40 40 2 Human needs for water are related (1) to caloric consumption, (2) to insensible loss, and (3) to the specific gravity of the urine. The infant must consume much larger amounts of water per unit of body weight compared with the adult, but when calculated per unit of caloric intake, the amounts required are almost identical. The daily consumption of fluid by the healthy infant is equivalent to 10–15% of body weight compared with 2-4% in the adult. The usual food of infants and children is high in water content; most of the solid food in the child's diet contains 60–70% water, with fruits and vegetables containing 90%. Water balance depends on variables, such as the protein and mineral content of diet, that determine solute load presented for renal excretion, metabolic and respiratory rates, and body temperature. Water requirements for low-birthweight infants are estimated at 85–170 mL/kg/24 hr. Fecal losses are small (3–10% of intake). Evaporation from lungs and skin accounts for 40–50% of intake (sometimes more) and renal excretion for 40–50% or more. 3 The kidney preserves the fluid and electrolyte equilibrium of the body by varying the osmolar content and volume of urine. Urine usually has a greater osmotic pressure (300–1,000 mOsm/L) than the internal environment (293 mOsm/L); maximum normal urinary concentration is approximately 600–700 mOsm/L. Table 2. Oral daily water comsumption at various ages Age Oral daily water comsumption (mL/kg/day) 0-3 days 80-100 3 days-6 months 130-160 6-12 months 125-145 1-4 years 110-135 10 years 70-85 <18 years 40-50 4 Energy Energy needs of children at different ages and under various conditions vary greatly. The approximate average expenditures of energy by the child 6-12 yr of age are basal metabolism, 50%; growth, 12%; physical activity, 25%; and fecal loss, about 8%, mainly as unabsorbed fat. Enteral and Parenteral Energy consumption of a newborn. Energy consumption Enteral Parenteral Basal metabolism 48 41 Growth 29 29 Physical activity 15 10 Fecal loss 18 - Thermoregulation 10 minimal 120 80 Total Table 4. Energy requirement at various body weights. Weight <10 kg 100 kcal/kg 10-20 kg 1000 + 50 kcal/kg > 20 kg 1500 + 20 kcal/kg 5 The daily requirement is approximately 80–120 kcal/kg for the 1st yr of life, with subsequent decreases of about 10 kcal/kg for each succeeding 3-yr period. Periods of rapid growth and development near puberty require increased caloric consumption. The distribution of calories in human milk, in most formulas, and in a well-balanced diet is similar. Distribution of calories Approximately 9- 15% of the calories are derived from protein, 45– 55% are derived from carbohydrate, and 35–45% are derived from fat. Each gram of ingested protein or carbohydrate provides 4 kcal. 1 g of long-chain fatty acids provides 9 kcal. Proteins Protein constitutes about 20% of adult body weight. Its amino acids are essential nutrients in forming cell protoplasm. The kind, number, and arrangement of amino acids in a protein molecule determine its characteristics. Twenty amino acids have been identified; eight were found to be essential for children and adults(Table-5). 6 Additionally arginine and histidine are essential for infants; cystine, and taurine are essential for low-birthweight infants. Nonessential amino acids can be synthesized and need not be supplied in the diet. New tissue cannot be formed without all of the essential amino acids simultaneously present in the diet; the absence or deficiency of only one essential amino acid results in a negative nitrogen balance. Table-5. Amino acids Essential amino acids Nonessential amino acids Valine Glycine Leucine Alanine Isoleucine Cyst(e)in→taurine Threonine Tyrosine→dopamine Lysine →noradrenaline Tryptophan→ 5-HT→ Serotonine Phenylalanine →Tyrosine Aspartic acid Glutamic acid→Gamma amino butyric acid (GABA) Methionine→→→ Cyst(e)in Serine Semi-essential Aspargine Histidine Arginine Glutamine Proline 7 Amino acids are reconstituted to functional human proteins (e.g., albumin, hemoglobin, hormones). Excess amino acids undergo deamination, and the nitrogenous portions are converted to urea in the liver and excreted by the kidneys. The carbon from amino acids is oxidized much like that of carbohydrate or fat; some amino acids are glycogenic; others are ketogenic. Exceptionally leucine is a purely ketogenic amino acid. Proteins cannot be effectively stored. In protein depletion states, proteins from muscle may be broken down to supply amino acids for more essential sites, such as the brain and for enzyme synthesis. Daily protein requirements at various ages are listed in Table-6 Table-6 Daily protein Daily protein Age requirements Age requirements 0-6 months 2 gr /kg 7-14 years 1.0 gr /kg 6-12 months 1.5 gr /kg 15-18 years 1.1 gr /kg 1-6 years 1.2 gr /kg Adult 0.8 gr /kg "Biologic value" of proteins indicates effectiveness of utilization; proteins of high biologic value have the quantity and distribution of essential amino acids appropriate for resynthesis of body tissues and provide little waste, as determined by nitrogen balance studies. 8 Carbohydrates Carbohydrates supply an important part of the body's energy needs. the monosaccharides the disaccharides glucose fructose galactose Lactose: glucose + galactose Sucrose: glucose + fructose Maltose: glucose + glucose the polysaccharides Starch: glucose + glucose + glucose ………. glucose + glucose Glycogen: (animal starch) Carbohydrate that is not oxidized (burned) or stored as glycogen is converted to fat. Foods with a high glycemic load and /or index (refined carbohydrates) overstimulate insulin secretion. High insulin levels cause insulin resistance in muscle and liver but not in fat tissue. While hyperinsulinemia causes fat depositon in the fed state, it does not give permission to hydrolysis of fats. Insulin resistance leads to common chronic diseases (Table-7). 9 Table-7. Diseases influenced by insulin resistance headaches reactive hypoglycemia arthritis multiple sclerosis coronary heart disease hemorrhoids Alzheimer Disease. rise in triglycerides varicose veins hyperactivity rise in LDL asthma anxiety decrease in HDL emphysema depression. wrinkles dental caries concentration grey hair periodontal disease difficulties baldness osteoporosis inappropriate behavior alcoholism hypertension decreased performance obesity food allergies drowsiness gallstones diabetes chromium deficiency stomach ulcer eczema copper deficiency appendicitis cataracts calcium deficiency fatty liver atherosclerosis magnesium deficiency Crohn's disease free radical formation breast cancer ulcerative colitis fluid retention ovary cancer dyspepsia myopia gastric cancer constipation macular degeneration prostate cancer bacterial infection gout rectum cancer candidiasis toxemia (pregnancy) colon cancer kidney damage premensturel syndrome gall bladder cancer. kidney stones 10 Fats Fats or their metabolic products form an integral part of cellular membranes and are efficient stores of energy. They impart palatability to food and serve as vehicles for fat-soluble vitamins A, D, E, and K. Approximately 98% of natural fats are triglycerides, three fatty acids combined with glycerol. The remaining 2% include free fatty acids, monoglycerides, diglycerides, cholesterol, and phospholipids (including lecithin, cephalin, sphingomyelin, and cerebrosides). Naturally occurring fats contain straight-chain fatty acids, both saturated and unsaturated, varying in length from 4 to 24 carbon atoms. The degree of absorption generally varies with the melting point, the degree of unsaturation, and the positions of the fatty acids on the glycerol molecule. Ingested triglycerides are partially hydrolyzed by lingual lipase and emulsified in the stomach. 11 Saturated fatty acids Butter Beef tallow Margarine Monounsaturated fatty acids (omega-9) Olive oil Hazelnut oil Fatty acids Poliunsaturated fatty acids (omega-3) Fish / liver oil Flaxseed oil Wall nut oil Canola oil Poliunsaturated fatty acids (omega-6) Corn Sun flower Soya Cotton 12 ESSENTIAL FATTY ACIDS. Essential fatty acids (EFA) are polyunsaturated and grouped into two families, the omega-6 EFAs and the omega-3 EFAs. Fats are molecules with a long carbon chain and they have two ends. One end has a methyl group and the other end has a carboxyl group. The Greek symbol "omega" is used as it is the last letter in the Greek alphabet. When omega is used in reference to fatty acids it is referring to the methyl end of the fatty acid. Thus Omega-3 (n-3)fatty acids refer to the family of fatty acids in which the first cis double bond closest to the methyl end of the fat is in the 3rd position. Omega-6 (n-6) refers to the family of fatty acids where the first cis double bond closest to the methyl end is in the 6th position. Although we do need both omega-3s and omega-6s it is becoming increasingly clear that an excess of omega-6 fatty acids can have dire consequences. Many scientists believe that a major reason for the high incidence of heart disease, hypertension, diabetes, obesity, premature aging, and some forms of cancer is the profound imbalance between our intake of omega-6 and omega-3 fatty acids. 13 14 Our ancestors evolved on a diet with a ratio of omega-6 to omega-3 of about 1:1. A massive change in dietary habits over the last few centuries has changed this ratio to something closer to 20:1 and even to 50:1 ! 15 Tissue phospholipids Fosfolipase A2 Lipooxigenase Dietary omega-6s Eicosapentoenoic acid (-) Cyclooxigenase (-) Dietary omega-3’s Prostaglandin H2 Leukotiriene A4 Hydrolase Leukotiriene B4 Thrombaxane A2 Prostaglandin E2 Inflamatory mediators Tissue phospholipids Fosfolipase A2 Lipooxigenase Dietary omega-3s Eicosapentoenoic acid (-) Cyclooxigenase (-) Dietary omega-6’s Prostaglandin H3 Leukotiriene A5 Hydrolase Leukotiriene B5 Prostaglandin E3 Thrombaxane A3 Antiinflamatory mediators 16 Inflamation (-) cytokines TNF-α interleukine-1(b) interleukine -6 •Omega-3 •Dehydroepiandrosterone •Vitamin K •Vitamin E •n-acetyl cystein •Nettle seed II. group prostaglandins, IV. I. and III. group prostaglandins, Group leukotiriens (omega-6) V. Group leukotiriens (omega-3) Inflamatory Antiinflamatory Hyperalgesic Analgesic Thrombotic Antithrombotic Mitogenic Antimitogenic 17 Sources and requirements The main sources of omega-6 fats are vegetable oils such as corn oil and soy oil that contain a high proportion of linoleic acid. Omega-3 fats are found in flaxseed oil, walnut oil, and marine plankton and fatty fish. The main component of flaxseed and walnut oils is alpha-linolenic acid while the predominant fatty acids found in fatty fish and fish oils are eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Humans do not synthesize linoleic or linolenic acid. Both must be supplied in the diet and are, therefore, "essential." Linoleic acid is the precursor of arachidonic acid, the prostaglandins, and the leukotrienes. Linolenic acid modulates the rate of production of arachidonic acid metabolites and forms longer chain unsaturated fatty acids, which may be essential for central nervous system structure and function. Essential fatty acids are necessary for growth, skin and hair integrity, regulation of cholesterol metabolism, lipotropic activity, decreased platelet adhesiveness, and reproduction. 18 Alfa-linolenic acid modulates the rate of production of arachidonic The relation of dietary fat intake to intimal fat streaking in the major arterial vessels in early life and atheromatous changes in adults remains to be clarified. Table. Diseases related to omega-3 fatty acids deficiency. Acne Diabetes Psychiatric Disorders Dermatitis AIDS Infection Allergies Inflamatory Diseases Alzheimer Breast Cancer Angina pectoris Breast cyst Atherosclerosis Palsy Arthritis Vision disorders Behavioral disorders Hypertension Senility Hyperactivity Immune deficiency Metastasis Heart disease Multipl Scleros Cancer Otoimmunity Cystic fibrosis Obesity Learning disorders Chronic fatigue syndrome Leukemia Psoriasis Lupus Reye syndrome Malnutrition Schizophrenia Menopause 19 Minerals Reproduction and maintenance of life is only possible by the actions of metal ions or minerals. The ash content of the fetus is about 3% of the body weight at birth. It increases continuously throughout childhood. Adult ash content is 4.35% of body weight; 83% is in the skeleton, and 10% is in the muscle. For each gram of protein retained, 0.3 g of mineral matter is deposited. Macrominerals. Minerals in which the requirements are over 50 mg/day for an adult. The principal macrominerals are cations such as calcium, magnesium, potassium, and sodium and their comparable anions are phosphorus, sulfur, and chloride. Microminerals: Minerals in which the requirements are below 50 mg/day for an adult. Iron, iodine, and cobalt appear in important organic complexes. The trace elements, copper, zinc, chromium, manganese, selenium, fluorine (?) and molybdenum have known metabolic roles; silicon, boron, nickel, aluminum, arsenic, bromine, and strontium are also present in the diet and in the body. 20 Vitamins The word "vitamin" refers to organic compounds required in minute amounts to catalyze cellular metabolism essential for growth or maintenance of the organism. Vitamins generally cannot be syhtnesized by the body and must be supplied by the diet. Bacterial Synthesis of Vitamins. Certain vitamins are synthesized in the human gastrointestinal tract; however, the extent to which they can meet the body's needs is uncertain. Once the bacterial flora of the intestinal tract have been established, vitamin K is produced and is available to the body. Pantothenic acid and biotin, essential to human metabolism, can be supplied by bacterial synthesis alone. Thiamine, riboflavin, niacin, vitamin B6, vitamin B12, and folic acid are synthesized in some species, but synthesis is limited or does not exist in humans. The kind of food or the nature of intestinal flora may affect vitamin production or availability. 21 Water soluble vitamins Water soluble vitamins Water soluble vitamins are shown in table. Because of their water solubility, excesses of these vitamins are excreted in urine and so rarely accumulate in toxic concentrations. They are heat-labile and can be absorbed in malabsorption syndromes. Fat soluble vitamins Fat soluble vitamins are shown in table. Because of their fat solubility, excesses of these vitamins are not excreted in urine and accumulate in toxic concentrations. They are heat-resistant and can not be absorbed in malabsorption syndromes. Table. Water and fat soluble vitamins Water soluble vitamins I. B complex vitamins are coenzymes of enzymatic reactions. B complex vitamins that have roles in energy metabolism Vitamin B1 (thiamin) Vitamin B2 (riboflavin) Vitamin B3 (Niacin= nicotinic acid) Vitamin B5 (pantothenic acid) Biotin Other B complex vitamins B12 vitamini (cyanocobalamin) Folic acid Vitamin B6 (pyridoxine) II. Vitamin C (antioxidant) Fat soluble vitamins Vitamin A (antioxidant) Vitamin E (antioxidant) Vitamin D (calcium metabolism) Vitamin K (coagulation) 22 Antioxidants What are free radicals? Free radicals are unstable because they have unpaired electrons in their molecular structure. Oxygen, or oxyl, free radicals are especially dangerous. These unstable molecules that interact quickly and aggressively with other molecules and destroy them. Physiological functions of free radicals Free radicals are involved in many cellular functions and are a normal part of living. For example; The mitochondria oxidizes the glucose and fatty acids and in so doing generates free radicals. White blood cells also use free radicals to attack and destroy bacteria, viruses and virus-infected cells. The detoxifying actions of the liver also require free radicals. Oxidative Stress Although free radicals have useful functions in the body under controlled conditions, they are extremely unstable molecules that can damage cells if left uncontrolled. Oxidative stress occurs when the available supply of the body’s antioxidants is insufficient to handle and neutralize free radicals of different types. 23 The result is massive cell damage that can result in cellular mutations, tissue breakdown and immune compromise. Free radicals destroy cellular membranes; enzymes and DNA. They accelerate aging and contribute to the development of many diseases, including cancer and heart disease. Free radicals are capable of penetrating into the DNA of a cell and damaging its “blueprint” so that the cell will produce mutated cells that can then replicate without normal controls. Toxins and free radicals Its important to note here that free radicals are also released in the body from the breaking down or detoxification of various chemical compounds. Foods and free radicals The major sources of dietary free radicals are chemicallyaltered fats from commercial vegetable oils, margarine or vegetable shortening and all oils heated to very high temperatures. Replace these harmful fats with natural, cold pressed oils such as olive oil (which can be used for cooking) and small amounts of flax oil or walnut oil (which should never be heated). Organic butter and tallow are also excellent choices, especially for cooking. Both of these naturally saturated fats are rich in certain fatty acids that have proven activity against bacteria, harmful yeasts, fungi and tumor cells. 24 Since saturated fats (from animal foods and the tropical oils) and monounsaturated oils (from olive oil and coldpressed nut oils) are more chemically stable, they are much less susceptible to oxidation and rancidity than their polyunsaturated cousins, which are mostly found in vegetable oils. Trans-fatty acids (TFAs), are produced during hot-processing of polyunsaturated oils. As a general rule, then, although the body does require a small amount of naturally occurring polyunsaturated oils in the diet each day, it’s best not to consume too much of them as they are more prone to free radical attack in the body. They can destroy the body’s supply of vitamin E, C and other antioxidants cause muscular lesions, brain lesions, and degeneration of blood vessels. Excessive sugar intake All dietary sugars get converted into triglycerides by the liver and are subject to free radical damage. These damaged fats then promptly attack your arteries and directly contribute to cardiovascular disease. Additionally, cancer and tumor cells feed off of sugar. It is for this reason that excessive sugar intake correlates very strongly with heart disease, cancer and a host of other ailments. ANTIOXIDANTS Fortunately, the body maintains a sophisticated system of chemical and biochemical defenses to control and neutralize free radicals. 25 Chemical antioxidants scavenge free radicals, that is, they stabilize the unstable free radicals by giving them the electron they need to “calm down.” But they also inhibit free radical formation inside the body The antioxidants are usually consumed or used up in this process—they sacrifice themselves. The main antioxidants are vitamins A, E and C, betacarotene, glutathione, bioflavonoids, selenium, zinc, CoQ10 (ubiquinone), and various phyto-chemicals from herbs and foods. Lipoic acid, repair enzymes such as catalase, superoxide dismutase (SOD), glutathione peroxidase. Melatonin, a hormone produced by the pineal gland, is also a potent antioxidant. Cholesterol, produced by the liver, is another major antioxidant, which the body uses to repair damaged blood vessels. It is probably for this reason that serum cholesterol levels rise as people age. With age comes more free radical activity and in response the body produces more cholesterol to help contain and control the damage. Of all the antioxidants, glutathione appears to be pivotal. Made up of three amino acids (cysteine, glycine, and glutamic acid), glutathione is part of the antioxidant enzyme glutathione peroxidase and is the major liver antioxidant. 26 Classification of antioxidants 1) Intercellular antioxidants A) Superoxide dysmutase (SOD). 2O2+2H+ —SOD→ H2O2+O2 SOD has two isoenzymes with Cu-Zn and Mn B) Catalase 2H2O2 —catalase→ 2H2O+O2 C) Glutathione peroxidase (GSH-Px) H2O2 + 2 glutathione (GSH) —(GSH-Px)→ 2H2O+ GSSG GSH-Px has two isoenzymes (selenium dependent and selenium independent) D) Cytochrom oxidase E)Glutathione:The most important intercellular antioxidant . glutathione (oxidised) —( glutathione reductase)→ glutathione (reduced) 2) Antioxidants in the membrane Vitamin E (alfa-tokoferol): the most powerful lip soluble antioxidant. Beta-carotene Lipids in membrane: Cholesterol and saturated fats in the membrane e have antioxidant power. 3) Extracellular antioxidants Ascorbic acid : The most powerful Transferrin: Lactoferrin: Haptoglobuline and hemopexine: . Ceruloplasmine Uric acid Bilirubine Mucus 27 WHERE DO THEY COME FROM? Replace these harmful fats with natural, cold pressed oils such as olive oil (which can be used for cooking) and small amounts of flax oil or walnut oil (which should never be heated). Food grade, unrefined coconut oil and organic butter are also excellent choices, especially for cooking. Both of these naturally saturated fats are rich in certain fatty acids that have proven activity against bacteria, harmful yeasts, fungi and tumor cells. Additionally, since saturated fats (from animal foods and the tropical oils) and monounsaturated oils (from olive oil and cold-pressed nut oils) are more chemically stable, they are much less susceptible to oxidation and rancidity than their polyunsaturated cousins, which are mostly found in vegetable oils. As a general rule, then, although the body does require a small amount of naturally occurring polyunsaturated oils in the diet each day, it’s best not to consume too much of them as they are more prone to free radical attack in the body. “A diet high in unsaturated fatty acids, especially the polyunsaturated ones, can destroy the body’s supply of vitamin E and cause muscular lesions, brain lesions, and degeneration of blood vessels. Care must be taken not to include a large amount of polyunsaturated oil in the diet 28 The best food sources for polyunsaturates are fish, flax oil, sesame oil, walnut oil and dark green, leafy vegetables. One caveat: canola oil is not recommended due to its chemical instability and its content of trans-fatty acids (TFAs), formed during processing. TFAs are increasingly being linked wtih cancer, immune system dysfunction and heart disease. The detoxification of drugs Free radicals are also released in the body from the detoxification of drugs (whether legal or illegal), artificial food colorings and flavorings, smog, preservatives in processed foods, alcohol, cigarette smoke, chlorinated drinking water, pesticides, radiation, cleaning fluids, heavy metals such as cadmium and lead, and assorted chemicals such as solvent traces found in processed foods and aromatic hydrocarbons such as benzene and naphthalene (found in moth balls). Psychological and emotional stress Even psychological and emotional stress can contribute to oxidative Stress. When the body is under stress, it produces certain hormones that generate free radicals. Moreover, the liver must eventually detoxify them and that process also generates free radicals. Heightened oxidative stress has also been observed in athletes after intensive workouts due to the physical stress placed on the body. Both physical and emotional stress also prompt the release of endogenous cortisol, an adrenal hormone that reduces inflammation, but also suppresses the immune system. 29 Illnesses Associated With Oxidative Stress GI Tract: Diabetes, pancreatitis, liver damage, and leaky gut syndrome Brain and Nervous System: Parkinson’s disease, Alzheimer’s disease, hypertension, multiple sclerosis, Down’s Syndrome Heart & Blood Vessels: Atherosclerosis, coronary thrombosis. Lungs: Asthma, emphysema, chronic pulmonary disease. Eyes: Cataracts, retinopathy, macular degeneration. Joints: Rheumatoid arthritis Kidneys: Glomerulonephritis Skin: “Age spots,” vitiligo, wrinkles. Body in General: Accelerated aging, cancer, autoimmune diseases, inflammatory states, AIDS and lupus. 30 Food sources of Antioxidants CoQ10 (ubiquinone): Beef heart, beef liver, sardines, spinach, peanuts Beta-carotene: All orange and yellow fruits and vegetables; dark green vegetables Zinc: Oysters, herring(Ringa), lamb, whole grains Selenium: Butter, meats, seafood, whole grains Vitamin A: Cod liver oil, butter, liver, all oily fish Vitamin E: Cold-pressed, unrefined nut and seed oils; wheat germ oil Vitamin C: Berries, greens, broccoli, kale, kiwi, parsley, guava Glutathione (GSH): Fresh fruits and vegetables, fresh meats, lowheat dried whey Bioflavonoids: Most fruits and vegetables, buckwheat Polyphenols: Green tea, berries. Herbal Sources: Milk thistle (Deve dikeni), ginkgo biloba, tumeric, curry Probiotics There are 100 trillion beneficial bacteria = probiotics (1.5 kg) in your bowels (Bowel flora). Bacteria in your bowels outnumber the cells in your body by a factor of 10 to one. This gut flora has incredible power over your body’s natural defense system (immune system) that keeps you healthy. 31 The health of your body is largely tied into the health of your gut, and it’s hard to have one be healthy if the other is not. This is an extremely complex living system that aggressively protects your body from outside offenders. A large part of the influence of the "bad" bacteria is on the intestinal lining (mucosal barrier) that is over 300 square meters, or about the size of a tennis court. Beneficial bacteria in your gut can help to boost the immune system, prevent allergic inflammation and food allergy, clear up eczema in children and heal the intestines from a variety of ailments. However, if you are eating as many sugars as the typical Western diet (about 100 kg per year) then you are feeding the "bad" bacteria, which are more likely to cause disease than promote health, rather than promoting the "good" bacteria that help protect you from disease. Exposure to chemicals will also contribute to this disruption in your gut microflora, and over time the imbalance will lead to illness. Gastrointestinal microflora promote potentially antiallergenic processes T-helper-1-type immunity Generation of transforming growth factor which has an essential role in suppression of T-helper-2-induced allergic inflammation and induction of oral tolerance IgA production, an essential component of mucosal immune defence. Effective in allergic inflammation and food allergy. Enhance gut-specific IgA responses, Promote gut barrier function and restore normal gut microecology 32 The well-known probiotics are fermented foods. Yogurt, raw milk, breast milk, prickles and kefir Microorganisms in Kefir LACTOBASILUS Lb. acidophilus Lb. brevis Lb. casei Lb. casei subsp. rhamnosus Lb. casei subsp. pseudoplantarum Lb. paracasei subsp. paracasei Lb. cellobiosus Lb. delbrueckii subsp. bulgaricus Lb. delbrueckii subsp. lactis Lb. fructivorans Lb. helveticus subsp. lactis Lb. hilgardii Lb. kefiri Lb. kefiranofaciens Lb. kefirgranum sp. nov Lb. parakefir sp. nov Lb. lactis Lb. plantarum ACETOBACTERS Acetobacter aceti A. rasens STREPTOCOCCİ/LAKTOCOCCİ Lactococci lactis subsp. lactis Lc. lactis var. diacetylactis Lc. lactis subsp. cremoris Streptococci salivarius subsp. thermophilus S. lactis Enterococcus durans Leuconostoc cremoris Leuc. mesenteroides Fungus Candida kefir C. pseudotropicalis C. rancens C. tenuis Kluyveromyces lactis Kluyveromyces marxianus var. marxianus K. bulgaricus K. fragilis / marxianus Saccharomyces subsp. Torulopsis holmii Saccharomyces lactis S. carlsbergensis S. unisporus **Debaryomyces hansenii **Zygosaccharomyces rouxii 33 Flavonoids Flavonoids are natural chemicals found in plants, fruits and vegetables. They’re actually the largest group of several thousand compounds belonging to the antioxidant-rich polyphenol family. While all flavonoids are antioxidants, some have stronger antioxidant properties than others, depending on their chemical structure. The flavonoids, have many health-promoting properties; Are powerful free radical scavengers that can boost the effectiveness of vitamin C in the antioxidant network Regulate nitric oxide, a potent free radical that is a regulator of blood flow Improve memory and concentration and are used to treat attention deficit disorder Keep your heart healthy in three important ways: They prevent blood clots, protect against oxidation of LDL (bad) cholesterol, and lower high blood pressure Improve sexual function in men Reduce inflammation and bolster immune function Prevent the development of Alzheimer’s disease, Relieve chronic fatigue syndrome Slow down aging Flavonoids are present in most all vegetables, including onions, broccoli and greens, as well as fruits such as apples, grapes and blueberries. Blueberries (yaban mersini): anthocyanin, the most powerful flavonoid Grape seed: proanthocyanidin Green tea: catechin Strawberries (çilek): anthocynanins and ellagic acid Black tea: teaflavin Raspberries (ahududu): anthocyanins, ellagic, coumaric and ferulic acid Citrus fruits: hesperidin, quercetine, tangeritine Onion: quercetin Framboise : ellagic cumaric and ferulic acids Lycopene: pigment that gives red color tomatoes, pink grapefruit and orange , watermelon, Betaine: pigment that gives purple color, beet, red cabbage 34